Apocrine metaplasia of the breast is a benign breast condition and is sometimes considered part of or associated with fibrocystic change. It is a common finding in the female breast, particularly after the age of 25, and many regard it as a normal component of the breast.
Seen mostly in women over the age of 50 years.
Metaplastic changes occur secondary to some kind of irritation, most often being a breast cyst. Apocrine-like cells form in a lining of developing microcysts due to the increased intraluminal pressure caused by secretions.
Mammographic features are nonspecific.
There are no distinguishing mammographic features, although a new or enlarging lobular, microlobulated mass or heterogeneous calcification cluster may sometimes represent apocrine metaplasia. When this is seen, a needle biopsy is required for definitive diagnosis 1.
Ultrasound may show a cluster of small (2-5 mm) anechoic foci with intervening septae 3.
Treatment and prognosis
When there is hyperplasia seen along with metaplasia there is an increased risk of developing breast cancer.
- 1. Kushwaha AC, O'toole M, Sneige N et-al. Mammographic-pathologic correlation of apocrine metaplasia diagnosed using vacuum-assisted stereotactic core-needle biopsy: our 4-year experience. AJR Am J Roentgenol. 2003;180 (3): 795-8. AJR Am J Roentgenol (full text) - Pubmed citation
- 2. Berg WA, Campassi CI, Ioffe OB. Cystic lesions of the breast: sonographic-pathologic correlation. Radiology. 2003;227 (1): 183-91. doi:10.1148/radiol.2272020660 - Pubmed citation
- 3. Warner JK, Kumar D, Berg WA. Apocrine metaplasia: mammographic and sonographic appearances. AJR Am J Roentgenol. 1998;170 (5): 1375-9. AJR Am J Roentgenol (abstract) - Pubmed citation
- 4. Eurorad teaching files : Case 6650
- 5. Doshi DJ, March DE, Crisi GM et-al. Complex cystic breast masses: diagnostic approach and imaging-pathologic correlation. Radiographics. 2007;27 Suppl 1 : S53-64. doi:10.1148/rg.27si075508 - Pubmed citation
- 6. Wells CA, Mcgregor IL, Makunura CN et-al. Apocrine adenosis: a precursor of aggressive breast cancer? J. Clin. Pathol. 1995;48 (8): 737-42. J. Clin. Pathol. (link) - Free text at pubmed - Pubmed citation
- 7. Paredes ES. Atlas of mammography. Lippincott Williams & Wilkins. (2007) ISBN:0781764335. Read it at Google Books - Find it at Amazon